If you need help - ask for it! Stop expecting everybody in the world to be a mind reader and then claiming they do not care when they are unable to read your mind! If you need help and go to the Dr or mental health be clear with them - most have no problem at all on here saying I just want to kill myself that is all I think about - but reflect back to your last Dr or mental health visit when they did nothing for you... the questions they use in assessment are fairly standard - may very from clinic to clinic - country to country - but in large part are the same- How often do you think about suicide? They are looking for frequency , intensity and duration. If you think about it all the time or the majority of the time SAY SO. "sometimes" lands you squarely in the middle of the scale. Intensity - are the brief passing thoughts, focused deliberation (weighing pros and cons) or intense considerations (already decided it is the best solution and justifying to yourself why). Once again - "sometimes I try to decide if I should or not" - very middle of scale. How long do these thoughts last "I don't know, a while" is not an answer and barely rates. Do you have a plan? If you do - tell them - they will ask about it, tell them the details - if you want help then be honest. Have you ever attempted before? If you have then say so "yes, I did this this and this" and when you did it - "umm, kinda, not really" does not get you help if the actual answer is "yes, I did this this and this with the intent to die" Do you self harm? If yes then say so - and how - do not expect them to search for scars or magically divine you do other things that do not leave scars as a method of of self harm. Do you feel hopeless? yes or no question - do not assume they should know that by your simple presence - "sometimes" is not an answer of great use Do you feel like a burden or others would be better off without you? yes or no question - do not assume they should know that by your simple presence - sometimes is not an answer of great use Do you have nightmares and insomnia - if yes they will want to know about sleep or lack of sleep and ask more questions Substance abuse - if you self medicate using alcohol, controlled substances, or illegal drugs this is not the time to be embarrassed and not admit it - at least if you want to get help. There are a good number of other factors that go into the assessment- their observations of you, the way you answer and speak, many things you have little or no control over - but if you answer completely and honestly to the basic questions then the rest is far more thorough and they have better ideas of what to look for. A bunch of "sometimes" "maybe" and "I don't know" responses will get you rated far below the immediate danger. I am in no way saying or implying that you should lie, but if you are hedging on the answers lying is what you are doing. Then they say go home, take a weekend off to relax, and give you a mild sleep aide and you say they are useless and do not help at all - it is YOU that made it impossible for them to help. And then you come and say they did nothing to help you, when in fact all they did was not have the ability to read your mind. Most places have a scoring system of sorts - and if you score below a certain level they may not even be allowed to give referrals or send for further more detailed evaluation - even if they suspect you are hedging. If your answers end up with a score of 65 and the requirements for a caregiver or facility is set at 75 you will not be sent as the evaluation checklist is part of the referral packet. When you get sent to psyche referral or psychiatrist or hospitalized your answers are far more important. All of the time there are statements on here "I lie to my therapist/psychiatrist." Then two sentences later say "Meds do not work for me" - Of course they did not work! It is like going to hospital in so much pain you can not bear it and telling them "it is uncomfortable" - if you tell them how bad the pain is they will give you something much stronger- if you say it is uncomfortable they will give you a tylenol. Do not blame the psych unit or treatment for the efficacy of the treatment you are receiving or assume no treatment works because they can not read your mind and determine the appropriate medication and dosage or amount/type of therapy that would be appropriate. Does the system suck? YES it does, and there will always be problems with it for numerous reasons. Sometimes you will be completely honest about everything and it still will not work well. That is the purpose of follow ups. Yes they are difficult things to talk openly about, but I am not talking about true revealing of history of past abuses and those sort of things. I am saying simply answer the questions truthfully and without hedging. It will greatly improve your odds of getting real help. You may also consider if they did nothing and 2 years later you are still complaining about it maybe the initial assessment of immediate risk was not wrong? That is in no way implying that things do not change or get worse sometimes, but deciding based on the results of an evaluation 2 years ago that it is useless to go back when you know you are much worse is not good decision making.